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The coronavirus challenge

According to Orb Media, during a pandemic, community health workers can also be used as translators, cultural mediators, and healthcare facilitators – traits which are often downplayed.  As the number of Covid-19 cases grew in Pakistan, LHWs from all over the country actively participated in coronavirus awareness campaigns.

Nimra Rasheed, who works for the Lady Sanitary Patrol (LSP), a programme that is run by the District Health Authority, Lahore, said that she received coronavirus awareness training in March.  “My duties were not only limited to creating awareness, but I was also responsible for collecting nasal swabs from Covid-19 patients and safely take them back to the labs,” she said. “That apart, I was also responsible for providing information to different families about the coronavirus.”

Similarly, Razia Begum from K-P was sent to her regular houses to create awareness about protective measures amid the pandemic. “I provided information about the concept of social distancing, the importance of washing hands and using sanitisers, and wearing a mask,” she said. “Ninety-nine per cent of the families I visited carefully listened to the instructions and asked pertinent questions for their safety. I also discussed the possible introduction of a Covid-19 vaccine in the coming year to mentally prepare the members of my community.”

Even though LHWs sincerely performed their duties during the Covid-19 campaign, Halima, Razia, and Bushra complained of receiving limited or no PPEs and sanitisers to protect themselves.  “I was just given a 50 ml sanitiser bottle. Many of us had to spend out of our own pockets to keep ourselves safe from the potentially deadly disease. If they deployed us, they should have taken care of us too,” Halima said.

Dr Jafri shared similar concerns about the safety of LHWs. Owing to their familiarity with the members of the community, LHWs have also played an especially important role in Covid-19 contact tracing, a practice used by health departments to prevent the spread of infectious diseases by identifying people who came in close contact with infected patients.

“[They diligently performed their jobs and can help in pandemic preparedness in future too, but there is a need to strengthen such awareness campaign by ensuring that workers are given adequate supplies of PPEs so that they can perform their jobs more reliably,” he said.

Dr Amina Khan opined that it is an obvious choice for the government to utilise the services of LHWs amid the pandemic as this is the only organised outreach (door-to-door) system in Pakistan which has proven to be effective. “If properly trained and compensated, the LHWs will further prove to be an asset and can bring about great results,” she said. “But it must be remembered that there is a fine line between utilising and misusing their services. We need to motivate them and compensate them fairly.”

On the other hand, Dr Fareeha Irfan, a medical doctor and health policy and management expert from Punjab, said that LHWs can help with Covid-19, but it is important to remember that they already have predefined jobs.

“Diverting that trained workforce toward a new, widespread problem would affect their existing work. While it makes sense to use them as the first line of defence, it is important to have the ability and capacity to hire additional workforce for this task so that LHWs can effectively focus on their original duties,” she opined.

She added that the same is true for their role in any pandemic preparedness planning. Their expertise in health communication and door-to-door service is a valuable asset on which any future pandemic planning (including vaccination, once it is available) should count on, but it’s important to continue routine preventive work which would not disrupt the important work that LHWs are doing.

“If additional tasks, such as Covid-19 related work, are assigned to LHWs, that is fine, but it should never be at the cost of their original duties.”

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